Gallbladder carcinoma with choledochoduodenal fistula: A case report with surgical treatment

A 79 year-old man was admitted to our hospital because of upper abdominal p ain and nausea. A mobile tumor was palpable in the right upper abdomen. Abd ominal ultrasonography, computed tomography and celiac angiography revealed a gallbladder tumor. Endoscopic retrograde cholangiopancreatography reveal ed a fistula 1.5cm oral to the orifice of the papilla of Vater, dilatation of the common bile duct, and a filling defect in the gallbladder. Pancreato duodenectomy associated with reconstruction using Imanaga's method was perf ormed under a pre-operative diagnosis of gallbladder carcinoma with choledo choduodenal fistula. The gallbladder contained a tumor and two bilirubin st ones impacted in the orifice of the duodenal papilla. Histological studies confirmed that the gallbladder tumor was a mucinous adenocarcinoma and had not infiltrated the bile duct. We speculated that choledochoduodenal fistul a stimulated the development of cancer due to chronic irritation from pancr eatic juice reflux.